Department of Economics and Business Economics

Alexander Paul

Patient cost-sharing, socioeconomic status, and children’s health care utilization

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Patient cost-sharing, socioeconomic status, and children’s health care utilization. / Nilsson, Anton; Paul, Alexander.

In: Journal of Health Economics, Vol. 59, No. May, 2018, p. 109-124.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

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Nilsson, Anton ; Paul, Alexander. / Patient cost-sharing, socioeconomic status, and children’s health care utilization. In: Journal of Health Economics. 2018 ; Vol. 59, No. May. pp. 109-124.

Bibtex

@article{7dc2f4e45e6a4c8bacc5fe9cb7181cf9,
title = "Patient cost-sharing, socioeconomic status, and children{\textquoteright}s health care utilization",
abstract = "This paper estimates the effect of cost-sharing on the demand for children{\textquoteright}s and adolescents{\textquoteright} use of medical care. We use a large population-wide registry dataset including detailed information on contacts with the health care system as well as family income. Two different estimation strategies are used: regression discontinuity design exploiting age thresholds above which fees are charged, and difference- in-differences models exploiting policy changes. We also estimate combined regression discontinuity difference-in-differences models that take into account discontinuities around age thresholds caused by factors other than cost-sharing. We find that when care is free of charge, individuals increase their number of doctor visits by 5–10%. Effects are similar in middle childhood and adolescence, and are driven by those from low-income families. The differences across income groups cannot be explained by other factors that correlate with income, such as maternal education.",
author = "Anton Nilsson and Alexander Paul",
year = "2018",
doi = "10.1016/j.jhealeco.2018.03.006",
language = "English",
volume = "59",
pages = "109--124",
journal = "Journal of Health Economics",
issn = "0167-6296",
publisher = "Elsevier BV",
number = "May",

}

RIS

TY - JOUR

T1 - Patient cost-sharing, socioeconomic status, and children’s health care utilization

AU - Nilsson, Anton

AU - Paul, Alexander

PY - 2018

Y1 - 2018

N2 - This paper estimates the effect of cost-sharing on the demand for children’s and adolescents’ use of medical care. We use a large population-wide registry dataset including detailed information on contacts with the health care system as well as family income. Two different estimation strategies are used: regression discontinuity design exploiting age thresholds above which fees are charged, and difference- in-differences models exploiting policy changes. We also estimate combined regression discontinuity difference-in-differences models that take into account discontinuities around age thresholds caused by factors other than cost-sharing. We find that when care is free of charge, individuals increase their number of doctor visits by 5–10%. Effects are similar in middle childhood and adolescence, and are driven by those from low-income families. The differences across income groups cannot be explained by other factors that correlate with income, such as maternal education.

AB - This paper estimates the effect of cost-sharing on the demand for children’s and adolescents’ use of medical care. We use a large population-wide registry dataset including detailed information on contacts with the health care system as well as family income. Two different estimation strategies are used: regression discontinuity design exploiting age thresholds above which fees are charged, and difference- in-differences models exploiting policy changes. We also estimate combined regression discontinuity difference-in-differences models that take into account discontinuities around age thresholds caused by factors other than cost-sharing. We find that when care is free of charge, individuals increase their number of doctor visits by 5–10%. Effects are similar in middle childhood and adolescence, and are driven by those from low-income families. The differences across income groups cannot be explained by other factors that correlate with income, such as maternal education.

U2 - 10.1016/j.jhealeco.2018.03.006

DO - 10.1016/j.jhealeco.2018.03.006

M3 - Journal article

C2 - 29723695

VL - 59

SP - 109

EP - 124

JO - Journal of Health Economics

JF - Journal of Health Economics

SN - 0167-6296

IS - May

ER -